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General NPI Number Information
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NPI Number | 1033656707
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Entity Type | Organization
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Legal Business Name | ALLORA CORP
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Dates
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Enumeration Date | 01/19/2017
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Last Update Date | 01/19/2017
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Provider Practice Location Address
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Address Line | 844 HOLYOAKE RD
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-2315
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Country | US
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Telephone | 618-789-0012
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 997
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City | EDWARDSVILLE
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State | IL
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Zip | 62025-0997
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Country | US
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Telephone | 618-789-0012
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Fax |
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Authorized Official
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Title or Position | PRES
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Name | DAVID THAYER
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Credential |
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Telephone | 618-789-0012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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